Doctor, get off my back! That costs too much!

By way of example, I'll tell you the real problem with health care in America. It's got less to do with tort law and access, and more to do with who's name is in the top left corner of the check.

I took a spill about a week ago. It's a miracle that I didn't break any bones. I was in a lot of pain, and needed to see a doctor. I asked friends for recommendations, and found a chiropractor nearby. Now having medical insurance through my employer, I went to the doctor's office without batting an eyelash... "I'll probably have to make a $20 co-pay or something, $50 at the worst", I thought.

Following the initial consultation, I paid $165 out of pocket, expecting that I'd see most of that money again when my insurance provider got the bill. I instructed the receptionist, "Please verify that your services are covered by my insurance provider, or you'll never see me again." "Of course, sir. When you return in the morning, we'll have that answer for you".

Fast forward one day. I show up for my appointment, and against my better judgment, went straight back for treatment without my answer. At the end of the session, I asked the question again. "I'm sorry, sir. We have not been able to confirm that your insurance provider covers our services. That will be $125, please". Ouch! "Okay, I'll pay for the services, but you'll never see me again until you can confirm coverage". "Of course, sir. Accept my apology, and a phone call later this afternoon with confirmation. Have a nice day."

You can probably guess what happened next... you guessed it, "Not covered". So there I was. $290 lighter on the back side, still in pain and needing treatment, but unwilling to fork over $100 a pop (pun intended) for treatment. So what did I do next? I did the same thing we all do for auto insurance, groceries, housing, etc. I shopped around! I entered the marketplace and sought out a merchant that met 2 requirements: quality and price.

The ubiquitous consumer practice of shopping around is absent (or at least compromised) in health care. As things are today, I (the consumer) have no motivation to seek out an ultimately less expensive alternative (as long as the service is "covered", I generally don't care how much my provider is paying).

It gets worse. During an unrelated stream of dialogue, I asked the same doctor where he sends his blood samples for processing. "I use one of the big two - it's totally random. It depends on which form I pull out.", he said. "Are their rates comparable?", I asked. "I don't know. Most of the time, the patient's insurance covers the cost, so it doesn't matter to me", he replied.

So there you have it. A system in which purchasing decisions are made on both ends by individuals with no pecuniary responsibility! It is a run-away train that needs to be derailed, or we're all doomed to spend ourselves into poorer health.

But changed to what? Changed for the sake of change? Changed to something that will exacerbate the problem? "But at least we did something". Are you kidding me?!

Adding a so called public option will not control costs. To the contrary, it seems obvious to me that it will increase costs. It seems obvious that the public option will destabilize the last remnants of market competition, a force that we all know controls costs (though not to a proper degree in this case because it's not a true market).

Is the United States Postal Service (USPS) as efficient as FedEx or UPS? Does the USPS drive down the cost of parcel transfer? Of course not. So if we see that logic, why on earth would we believe that government provided health care could reduce the cost of seeing the doctor, let alone cost less (as is being touted by President Obama and some members of Congress).

I could refute ethical arguments justifying public health care. I could get into the ideology and politics of forced compassion. Here, I have done neither. I've only attempted to demonstrate the lunacy in believing that a public option could or will improve our collective financial position with respect to health care. It's laughable.

I welcome your comments and dialogue.

White Oppression, 21st Century Style

Well, it's official. It's okay to impute white men for any malady that befalls us. Feel free to openly state, "what goes around comes around". Fear not as you affirm that selecting a white man in lieu of anyone else is "disgraceful". Say these things and more, and do so without fear of reproach.

As we get our daily updates on the Sonia Sotomayor confirmation hearings, newspaper op-eds and blog posts abound with this new-found freedom of expression. It's not that white men are for the first time "evil". The difference is now, it's mainstream.

Consider the following:

In Whose Identity Politics?, Washington Post Op-Ed columnist Eugene Robinson wrote,

"Yes, justice is supposed to be blind. But for most of our nation's history, it hasn't been -- and women and minorities are acutely aware of how our view of justice has evolved, or been forced to evolve."

More overtly, The New York Times' Maureen Dowd stated in White Man's Last Stand,

"It was a disgrace that W. appointed two white men to a court stocked with white men."

Why is this kind of rhetoric acceptable? What happened to Dr. King's dream? Does it not include white men?

I'll start by dissecting Mr. Robinson's excerpt. He starts by stating that justice has not been blind for women and minorities (true). I'll assume he's inferring that most of the injustice has been adjudicated by white men (also true). Mr. Robinson is trying to excuse Judge Sotomayor's empathetic approach to Law (my opinion). If I can paraphrase, "Since white men did it to us, we can/should now do it to them, or at least be excused for doing so. What goes around comes around!"

Before I get to my point, let's turn for a moment to Ms. Dowd's comment. So selecting two white men from a pool of mostly white men is a disgrace, huh? Then where on the "disgrace meter" does Bill Clinton fall for appointing Stephen Breyer to the highest court in the land? The last time I checked, justice Beyer is white. And What about Bush 41? He appointed two conservative men - ouch! But Justice Thomas is black, so does he get any points for that? Am I to assume that you agree with Sotomayor, and feel that qualified white men must be overlooked?

All of this is troubling to me. In America, it's racism and sexism. In my native Kenya, it's tribalism. On either continent, the oppressed feel justified in retribution through an "it's our turn to eat" mentality. It's unfair and unwise. It's taking the low road, and it inflicts a condition of inequality across more levels than it heals. If this kind of rhetoric is not challenged at its core, we can never get to an "all are equal" society. I sometimes get the feeling that there are those that benefit from inequality, and they are willing to do anything to maintain it - and they ain't white men (at least not exclusively).

I'm not suggesting we feel sorry for white men. Nor am I about to propose a government program to help oppressed white men all over this land. After all, being white and male are still great commodities. it's just simply not fair to treat anyone like this because of the past (or the present). And this, from people who claim that their political party has moral authority on fairness. Wow.